Diverse Sample Of Children Research Articles

Intrapartum exposure to synthetic oxytocin, maternal BMI, and neurodevelopmental outcomes in children within the ECHO consortium

BackgroundSynthetic oxytocin (sOT) is frequently administered during parturition. Studies have raised concerns that fetal exposure to sOT may be associated with altered brain development and risk of neurodevelopmental disorders. In a large and diverse sample of children with data about intrapartum sOT exposure and subsequent diagnoses of two prevalent neurodevelopmental disorders, i.e., attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), we tested the following hypotheses: (1) Intrapartum sOT exposure is associated with increased odds of child ADHD or ASD; (2) associations differ across sex; (3) associations between intrapartum sOT exposure and ADHD or ASD are accentuated in offspring of mothers with pre-pregnancy obesity.MethodsThe study sample comprised 12,503 participants from 44 cohort sites included in the Environmental Influences on Child Health Outcomes (ECHO) consortium. Mixed-effects logistic regression analyses were used to estimate the association between intrapartum sOT exposure and offspring ADHD or ASD (in separate models). Maternal obesity (pre-pregnancy BMI ≥ 30 kg/m2) and child sex were evaluated for effect modification.ResultsIntrapartum sOT exposure was present in 48% of participants. sOT exposure was not associated with increased odds of ASD (adjusted odds ratio [aOR] 0.86; 95% confidence interval [CI], 0.71–1.03) or ADHD (aOR 0.89; 95% CI, 0.76–1.04). Associations did not differ by child sex. Among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of offspring ADHD (aOR 0.72; 95% CI, 0.55–0.96). No association was found among mothers without obesity (aOR 0.97; 95% CI, 0.80–1.18).ConclusionsIn a large, diverse sample, we found no evidence of an association between intrapartum exposure to sOT and odds of ADHD or ASD in either male or female offspring. Contrary to our hypothesis, among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of child ADHD diagnosis.

Associations Between Neighborhood Racialized Economic Segregation with Cardiometabolic Health and Cortisol in a Racially/Ethnically Diverse Sample of Children from Minneapolis-St. Paul.

Past research shows that structural racism contributes to disparities in cardiometabolic health among racially/ethnically minoritized populations. This cross-sectional study examined the correlation between census tract-level racialized economic segregation and child health metrics among a racially and ethnically diverse cohort of 350 children (ages 6.5-13.8) from Minneapolis-St. Paul, MN. A consistent cardiometabolic and cortisol outcome gradient was observed across the index of concentration at the extremes tertiles, such that health risk factors increased as tract privilege decreased. Racialized economic segregation was associated with less favorable child health outcomes, underscoring the potential importance of place-based interventions for promoting children's health.

Longitudinal associations between parenting practices and children’s later decision-making competence

Developmental research has suggested that certain parenting practices impact the development of children’s later risk behaviors. However, little evidence exists regarding how parenting may impact a child’s actual decision-making skills later in life. This study examined the degree to which earlier child-reports of parenting practices (assessed at age 10–12 and 12–14), specifically monitoring/involvement, firm/lax control, and psychological control, predicted decision-making competence (DMC), a measure of decision-making skills, at age 19. We conducted these analyses on a large, diverse sample of children (N = 775; 227 Female, 21.8% African-American); approximately half had at least one parent with a positive Substance Use Disorder (SUD) diagnosis. Analyses revealed that children reporting greater levels of psychological control demonstrated lower DMC performance at age 19, holding other parenting variables, level of neighborhood disadvantage, and parental SUD status constant. We relate these results to the broader effects of psychological control on decision-making and self-regulatory capabilities.

Component-specific developmental trajectories of ERP indices of cognitive control in early childhood

Early childhood is characterized by robust developmental changes in cognitive control. However, our understanding of intra-individual change in neural indices of cognitive control during this period remains limited. Here, we examined developmental changes in event-related potential (ERP) indices of cognitive control from preschool through first grade, in a large and diverse sample of children (N = 257). We recorded ERPs during a visual Go/No-Go task. N2 and P3b mean amplitudes were extracted from the observed waveforms (Go and No-Go) and the difference wave (No-Go minus Go, or ∆). Latent growth curve modeling revealed that while N2 Go and No-Go amplitudes showed no linear change, P3b Go and No-Go amplitudes displayed linear decreases in magnitude (became less positive) over time. ∆N2 amplitude demonstrated a linear increase in magnitude (became more negative) over time whereas ∆P3b amplitude was more positive in kindergarten compared to preschool. Younger age in preschool predicted greater rates of change in ∆N2 amplitude, and higher maternal education predicted larger initial P3b Go and No-Go amplitudes in preschool. Our findings suggest that observed waveforms and difference waves are not interchangeable for indexing neurodevelopment, and the developmental trajectories of different ERP indices of cognitive control are component-specific in early childhood.

Restricted and repetitive behaviors and their developmental and demographic correlates in 4-8-year-old children: A transdiagnostic approach.

Background: Restricted and repetitive behaviors (RRBs) are a broad class of behaviors characterized by frequent action repetition and intense preference for sameness. Research has predominantly focused on RRBs in diagnosed clinical groups, particularly in autism spectrum disorder and genetic disorders. Using a transdiagnostic approach, the current study examined RRBs in a diverse sample of children in relation to developmental and demographic correlates (age, language, non-verbal ability, child anxiety, sex, and socioeconomic status). Separate analyses examined two RRB subtypes; repetitive sensory and motor behaviors (RSMB) and insistence on sameness (IS). Method: Children (N = 260, age 4-8 years, 174 male, 86 female) in mainstream schools identified by teachers as having behavioral, emotional, and/or cognitive difficulties, were assessed using the Repetitive Behavior Questionnaire-2 (RBQ-2), the British Picture Vocabulary Scale (BPVS), Lucid Ability Scale, the Welsh Index of Multiple Deprivation (WIMD) and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Recruitment excluded diagnosed clinical conditions. The Strengths and Difficulties Questionnaire (SDQ) was used to assess children's difficulties. Results: RRB scores were of high frequency and the scores for the IS were higher than for RSMB. The severity of anxiety symptoms and male sex were significantly associated with both RRB subtypes, and younger age and SES scores were associated with IS. Elevated RRB total and subtype scores were significantly related to SDQ scores for emotion, conduct, hyperactivity, and peer-relations. Discussion: The study provides the first evidence of RRBs in a diverse sample of young children with emerging difficulties in behavior, cognition, and/or emotion. The results contribute to proposals about psychological development in RRB and indicate that RRBs are best represented on a continuum of severity found across children in the early school years. The results support previous findings of a relation between RRB and anxiety reported in clinical samples and importantly, they indicate that it is time to move beyond the study of categorically defined groups and consider correlates of RRBs that include broad indices of mental health and well-being.

Comparison of Long-Term Complications of COVID-19 Illness among a Diverse Sample of Children by MIS-C Status.

Most pediatric COVID-19 cases are asymptomatic; however, a small number of children are diagnosed with multisystem inflammatory syndrome in children (MIS-C), a rare but severe condition that is associated with SARS-CoV-2 infection. Persistent symptoms of COVID-19 illness in children diagnosed with/without MIS-C is largely unknown. A retrospective EHR review of patients with COVID-19 illness from one pediatric healthcare system to assess the presence of acute (<30 days) and chronic (≥30, 60–120, and >120 days) long-term COVID symptoms was conducted. Patients/caregivers completed a follow-up survey from March 2021 to January 2022 to assess the presence of long COVID. Results showed that non-MIS-C children (n = 286; 54.49% Hispanic; 19.23% non-Hispanic Black; 5.77% other ethnicity; 79.49% government insurance) were younger (mean age 6.43 years [SD 5.95]) versus MIS-C (n = 26) children (mean age 9.08 years, [SD 4.86]) (p = 0.032). A share of 11.5% of children with MIS-C and 37.8% without MIS-C reported acute long COVID while 26.9% and 15.3% reported chronic long COVID, respectively. Females were almost twice as likely to report long symptoms versus males and those with private insurance were 66% less likely to report long symptoms versus those with government insurance. In conclusion, a substantial proportion of ethnically diverse children from low resource backgrounds with severe COVID illness are reporting long-term impacts. Findings can inform pediatric professionals about this vulnerable population in post-COVID-19 recovery efforts.

Internalizing-Externalizing Comorbidity and Impaired Functioning in Children.

Background: The comorbidity of mental illnesses is common in child and adolescent psychiatry. Children with internalizing–externalizing comorbidity often experience worse health outcomes compared to children with a single diagnosis. Greater knowledge of functioning among children with internalizing–externalizing comorbidity can help improve mental health care. Objective: The objective of this exploratory study was to examine whether internalizing–externalizing comorbidity was associated with impaired functioning in children currently receiving mental health services. Methods: The data came from a cross-sectional clinical sample of 100 children aged 4–17 with mental illness and their parents recruited from an academic pediatric hospital. The current mental illnesses in children were measured using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), and the level of functioning was measured using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Linear regression was used to estimate the association between internalizing–externalizing comorbidity and level of functioning, adjusting for demographic, psychosocial, and geographic covariates. Results: Internalizing–externalizing comorbidity in children was associated with worse functioning compared to children with strictly internalizing comorbidities, β = 0.32 (p = 0.041). Among covariates, parent’s psychological distress, β = 0.01 (p = 0.004), and distance to the pediatric hospital, β = 0.38 (p = 0.049) were associated with worse functioning in children. Conclusions: Health professionals should be mindful that children with internalizing–externalizing comorbidity may experience worsening functioning that is disruptive to daily activities and should use this information when making decisions about care. Given the exploratory nature of this study, additional research with larger and more diverse samples of children is warranted.

Resilience Is Associated with Improved Emotion Regulation and Internalizing Symptoms Following Transdiagnostic Treatment in a Diverse Sample of Children

Resilience Is Associated with Improved Emotion Regulation and Internalizing Symptoms Following Transdiagnostic Treatment in a Diverse Sample of Children

Belt fit for children in vehicle seats with and without belt-positioning boosters

Objective The purpose of the current study is to use 3D technology to measure in-vehicle belt fit both with and without booster seats across different vehicles among a large, diverse sample of children and to compare belt fit with and without a booster. Methods Lap and shoulder belt fit were measured for 108 children ages 6–12 years sitting in the second-row, outboard seats of three vehicles from October 2017 to March 2018. Each child was measured with no booster, a backless booster, and a high-back (HB) booster in three different vehicles. Alternative high-back (HB HW) and backless boosters that could accommodate higher weights were used for children who were too large to fit in the standard boosters. Lap and torso belt scores were computed based on the belt location relative to skeletal landmarks. Results Both lap and torso belt fit scores were significantly different across vehicles when using the vehicle belt alone (no booster). In all vehicles, lap belt fit improved when using boosters compared with no booster among children ages 6–12 years in rear seats—with one exception of the HB HW booster in the minivan. Torso belt fit improved when using boosters compared with no booster in the sedan, and torso belt fit improved in the minivan and SUV with the use of HB and HB HW boosters when compared with no booster. Conclusions Lap and torso belt fit for children ages 6–12 years in rear seats was substantially improved by using boosters. Parents and caregivers should continue to have their children use booster seats until vehicle seat belts fit properly which likely does not occur until children are 9–12 years old. Decision makers can consider strengthening child passenger restraint laws with booster seat provisions that require children who have outgrown car seats to use booster seats until at least age 9 to improve belt fit and reduce crash injuries and deaths.

Longitudinal Association between Weight Status, Aerobic Capacity, Muscular Strength, and Endurance among New York City Youth, 2010-2017.

Background: Child weight status is inversely associated with fitness, but less is known about this relationship across fitness domains. This study examined the longitudinal association between weight status and fitness domains in a large, diverse sample of children. Methods: Data were drawn from the New York City Fitnessgram (2010-2011 to 2017-2018). Height and weight were collected annually and converted to weight status using Centers for Disease Control and Prevention growth charts. Aerobic capacity, muscular strength, and endurance were measured as age and sex standardized z-scores based on the fitness performance tests. Repeated-measures multilevel models were run testing the association between weight status and 1-year lagged fitness domains. Results: The sample included 917,554 children (51.8% male, 39.3% Hispanic, 29.9% non-Hispanic Black, 13.9%, 4.7%, and 1.7% class I, II, and III obesity, respectively). For each fitness domain, fitness scores decreased with increasing weight status across all demographic categories, with the lowest fitness scores observed in children with the most severe obesity, and highest magnitude of effects for aerobic capacity, and particularly among boys, non-Hispanic Whites, and older youth. For example, compared with youth with healthy weight, youth with overweight had 0.28 standard deviation lower aerobic capacity performance [confidence interval (95% CI): -0.29 to -0.28], followed by class 1 obesity (β = -0.57, 95% CI: -0.58 to -0.57), class 2 obesity (β = -0.88, 95% CI: -0.88 to -0.88), and class 3 obesity (β = -1.19, 95% CI: -1.20 to -1.18). Conclusions: Compared with youth with healthy weight, youth at every other weight status had lower subsequent fitness, with the magnitude of the relationship increasing as weight status increased. Future research should examine interventions targeting aerobic capacity to reduce fitness disparities.

Health Service Utilization Among Children and Adolescents with Posttraumatic Stress Disorder: A Case-Control Study.

Trauma exposure is widely prevalent, with more than 60% of adolescents having experienced at least 1 traumatic event and a third of those at high risk to develop posttraumatic stress disorder (PTSD). Data are scarce and out of date on the services children and adolescents with PTSD receive, impeding efforts to improve care and outcomes. This study examines health service use for a large and diverse sample of children and adolescents with and without a diagnosis of PTSD. Using a matched case-control study, we gathered information from 4 large health care systems participating in the Mental Health Research Network. Data from each site's electronic medical records on diagnoses, health care encounters, and demographics were analyzed. Nine hundred fifty-five 4- to 18-year-olds with a diagnosis of PTSD were identified and matched on a 1:5 ratio to 4770 controls. We compared cases with controls on frequency of service use in outpatient primary care, medical specialty care, acute care, and mental health care. We also assessed psychotropic medication use. Children and adolescents diagnosed with PTSD used nearly all physical and mental health service categories at a higher rate than controls. However, one-third of children and adolescents did not receive even 1 outpatient mental health visit (36.86%) during the year-long sampling window. Our findings suggest that children and adolescents diagnosed with PTSD may have unmet mental health needs. They are high utilizers of health services overall, but lower utilizers of the sectors that may be most helpful in resolving their symptoms.

Emotional Availability as a Moderator of Stress for Young Children and Parents in Two Diverse Early Head Start Samples.

Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent-child relationship quality (e.g., EA) for the transmission of parents' early life adversity on their children's HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.

Evaluation of the International Spinal Cord Injury Bowel Function Basic Data Set Version 2.0 in Children and Youth With Spinal Cord Injury.

To establish the utility and feasibility of the International Spinal Cord Injury/Dysfunction (SCI/D) Bowel Function Basic Data Set Version 2.0 in pediatric SCI populations. This was a noninterventional, repeated measure design conducted in Pennsylvania, Maryland, Illinois, Kentucky, and South Carolina. The International Spinal Cord Injury/Dysfunction (SCI/D) Bowel Function Basic Data Set Version 2.0 was administered repeatedly, twice at the point of care and once over the phone. Time to complete the data set was recorded. Inter- and intrarater reliability was examined by intraclass correlation coefficients (ICC) with 95% confidence intervals (CI), and agreement between the bowel function basic data set variables and medical records was calculated using percentages. Intrarater reliability involved the same person administering the data once at the point of care and once over the phone. Forty-one children/youth ages 1 to 20 years participated in this study. Average time to complete the data set was 5.17 minutes. Interrater reliability was good to excellent (ICC ≥ 0.75) for most variables. Five variables had moderate interrater reliability (ICC = 0.05-0.74) and three had poor interrater reliability (ICC < 0.05). With the exception of one variable that had poor intrarater reliability (constipating agent, ICC = 0.00) and one that approached moderate reliability (digital evacuation, ICC = 0.74), intrarater reliability was good to strong for every bowel variable (ICC = 0.88-1.00). Only 12 (32%) medical records had explicit documentation of one or more of the variables on the Basic Bowel Function Basic Data Set V2.0. The results support future research with a larger and more diverse sample of children with SCI to build upon the psychometric work described herein.

The Head-Toes-Knees-Shoulders Revised: Links to Academic Outcomes and Measures of EF in Young Children.

The measurement of self-regulation in young children has been a topic of great interest as researchers and practitioners work to help ensure that children have the skills they need to succeed as they start school. The present study examined how a revised version of a commonly used measure of behavioral self-regulation, the Head-Toes-Knees-Shoulders task (HTKS) called the HTKS-R, and measures of executive function (EF) was related to academic outcomes between preschool and kindergarten (ages 4–6years) in a diverse sample of children from families with low income participating in Head Start in the United States. Participants included 318 children (53% female; 76% White; and 20% Latino/Hispanic) from 64 classrooms in 18 Head Start preschools who were followed over four time points between the fall of preschool and the spring of kindergarten. Results indicated that children with higher HTKS-R scores had significantly higher math and literacy scores at all-time points between preschool and kindergarten. The HTKS-R was also a more consistent predictor of math and literacy than individual EF measures assessing inhibitory control, working memory, and task shifting. Parallel process growth models indicated that children who had high initial scores on the HTKS-R also had relatively higher initial scores on math and literacy. In addition, growth in children’s scores on the HTKS-R across the preschool and kindergarten years was related to growth in both children’s math and literacy scores over the same period independent of their starting points on either measure. For the HTKS-R and math, children’s initial scores were negatively associated with growth over the preschool and kindergarten years indicating that lower skilled children at the start of preschool started to catch up to their more skilled peers by the end of kindergarten.

Fine particulate matter relates to white matter microstructure alterations in U.S. children

BACKGROUND AND AIM: Recent epidemiological findings have increased concern that exposure to fine particulate matter air pollution (aerodynamic diameter ≤2.5 µm; PM2.5) may be neurotoxic, even at low levels. Earlier human MRI and animal studies suggest that PM2.5 may impact white matter, yet questions remain about potential localized effects on microstructure. The goal of the current cross-sectional study was to examine how PM2.5 exposure relates to white matter microstructure in a large, diverse sample of children. METHODS: We examined the associations between annual average outdoor PM2.5 exposure and white matter microstructure in 7,602 9-10 year-old children from the landmark Adolescent Brain Cognitive Development study. Diffusion Tensor Imaging was used to characterize white matter microstructure using fractional anisotropy (FA). Annual average PM2.5 concentrations were assigned to the primary residential address at the baseline visit in 2016-2018 using an ensemble-based model approach. RESULTS:After correcting for multiple comparisons and adjusting for study site (n=21), socio-demographics, and MRI-related covariates, residential PM2.5 exposure (mean 7.65; range 1.72–15.90 ug/m3) was found to have significant non-linear associations with FA in multiple tracts. Increasing exposure to PM2.5 was associated with bilateral increases in FA in the uncinate fasciculus, superior longitudinal fasciculus, and inferior longitudinal fasciculus and bilateral decreases in the cingulate cingulum. PM2.5 exposure from 1.72 to 7.5 ug/m3 was also positively associated with increases in the left hemisphere fornix and right hemisphere anterior thalamic radiation. CONCLUSIONS:White matter microstructure in today’s developing youth may be affected by ambient fine particulate matter. Different patterns were observed in the left and right hemispheres and along specific white matter tracts. Our findings suggest that annual average PM2.5 exposure may relate to greater restricted diffusion as indexed by FA in tracts important for motor, emotion, and attention, which may reflect a combination of alterations in myelination, microarchitecture, and/or packing density. KEYWORDS: Air pollution, Particulate matter, Neurodevelopmental outcomes, Children's environmental health

Focusing on Young Children in Pediatric Psychology Research: Introduction to the Special Issue on Young Children

Abstract This special issue focusing on pediatric psychology research in young children highlights 15 papers that focus on infants through preschoolers. Studies selected for inclusion cover a range of pediatric health conditions such as food allergy, medical trauma, injuries/traumatic brain injury, cancer, inflammatory bowel disease, pain, and sleep. The inherent challenges of researching young children are described, and studies vary in their methods for assessment and intervention; multiple studies include an observational component or developmental evaluation. Six of the studies employ diverse samples of children and/or parents and demonstrate the feasibility as well as importance of increasing our understanding of factors related to health disparities. Taken together, the special issue demonstrates the high quality of research focusing on young children. As the special issue editors, we hope this collection will spark an interest in others to focus on research with young children across pediatric populations.

Exposure to Negative Weight Talk From Family Members Is Associated With Weight Bias Internalization in Children

ObjectivesFrequent exposure to negative familial weight talk (NFWT), such as teasing or critical comments about weight from family members, may contribute to weight bias internalization (WBI) in children. WBI entails applying negative weight-based stereotypes to oneself and results in self-devaluation. Higher levels of WBI are linked to adverse outcomes, such as low self-esteem and disordered eating. We examined the association between NFWT exposure and WBI in a diverse sample of children from the Greater Boston Area. MethodsBaseline data on 137 parent-child dyads were analyzed. Children, 9–14yo, completed six items measuring NFWT frequency on a 6-point Likert scale (“never” to “almost every day”) from parents, siblings, and other household family members. Responses were converted to times in the past 3 months, summed, and dichotomized as < 9 times vs. ≥9 times. Children completed the WBI Scale–Modified indicating their agreement with applying negative weight-based statements to themselves on a 6-point Likert scale (“strongly disagree” to “strongly agree”). Responses were averaged and the mean WBI score was dichotomized as “low” (<3.0) versus “moderate-high” (≥3.0). ResultsOver half (52%) of the children were girls and 30% had overweight/obesity (BMI > 85th percentile). Half of the parents were non-Hispanic white. The mean child WBI score was 2.1 (SD = 0.9) and 15% had moderate-high levels of WBI. The median NFWT frequency was 0 (IQR = 6.0) and 25% reported NFWT ≥ 9 times. Children exposed to NFWT ≥ 9 times were 8.2 times more likely to have moderate-high levels of WBI than children exposed to NFWT < 9 times in the past 3 months (prevalence ratio = 8.2, 95%CI = 3.4 to 20.0, P < 0.001, by log binomial regression adjusted for child weight and parent race/ethnicity). ConclusionsFamily members appear to be a salient source of weight stigma in children. Exposure to NFWT as little as 3 times per month was significantly associated with moderate-high levels of WBI in this diverse sample of children. More research is needed to understand the impact of NFWT on child WBI, such as differences across racial/ethnic groups, by source (i.e., parents versus siblings), and across the lifespan. Funding SourcesNational Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Drug Abuse of the National Institutes of Health.

Asthma and Physical Activity in Urban Children.

Asthma and obesity disproportionately affect urban minority children. Avoidance of physical activity contributes to obesity, and urban children with asthma are at risk for lower levels of physical activity. We examined associations between lung function and moderate to vigorous physical activity (MVPA) and moderators of this association in a diverse sample of children with asthma. Urban children (N = 142) ages 7-9 with persistent asthma and their caregivers completed a study of asthma and physical activity. Longitudinal mixed effects models examining daily-level asthma and physical activity evaluated the association between asthma and MVPA, and the moderating effect of weight, and cultural/contextual factors on this association. Average daily MVPA was below recommended guidelines. Differences in MVPA were found by racial/ethnic group (p = .04) and weight (p = .001). Poorer asthma status was associated with lower MVPA in Latino and Black participants (p's < .05), and in normal weight youth (p = .01). Body mass index (BMI) moderated the association between asthma and MVPA. Those with lower BMI had more optimal asthma status and higher MVPA levels, whereas associations attenuated for participants with higher BMI (p = .04). Caregivers' perceptions of neighborhood safety and fear of asthma were marginally associated with children's symptoms and MVPA: as perceptions of safety decreased and fear increased, associations between asthma and MVPA weakened (p's = .09 and .07, respectively). Suboptimal asthma status is associated with less MVPA in urban children. Weight status and cultural/contextual factors play a role in the association and are worthy targets for future research and intervention.

The multivariate physical activity signature associated with metabolic health in children and youth: An International Children’s Accelerometry Database (ICAD) analysis

There is solid evidence for an association between physical activity and metabolic health outcomes in children and youth, but for methodological reasons most studies describe the intensity spectrum using only a few summary measures. We aimed to determine the multivariate physical activity intensity signature associated with metabolic health in a large and diverse sample of children and youth, by investigating the association pattern for the entire physical intensity spectrum. We used pooled data from 11 studies and 11,853 participants aged 5.8–18.4 years included in the International Children's Accelerometry Database. We derived 14 accelerometry-derived (ActiGraph) physical activity variables covering the intensity spectrum (from 0–99 to ≥8000 counts per minute). To handle the multicollinearity among these variables, we used multivariate pattern analysis to establish the associations with indices of metabolic health (abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure). A composite metabolic health score was used as the main outcome variable. Associations with the composite metabolic health score were weak for sedentary time and light physical activity, but gradually strengthened with increasing time spent in moderate and vigorous intensities (up to 4000–5000 counts per minute). Association patterns were fairly consistent across sex and age groups, but varied across different metabolic health outcomes. This novel analytic approach suggests that vigorous intensity, rather than less intense activities or sedentary behavior, are related to metabolic health in children and youth.

Parenting and social-ecological correlates with children's health behaviours: A latent profile analysis.

Paediatric obesity poses dangers to children's short and long-term health. Multi-level ecological models posit how children's health behaviours are influenced by interpersonal relationships. To identify profiles of individual and interpersonal health behaviours and parenting skills among caregivers and their children with elevated BMI. Participants were 240 children (63.7% Latino) ages 5 to 12 years with body mass index ≥85th percentile and their caregivers in a paediatric weight management intervention trial. A latent profile analysis was used to identify profiles among caregiver report of parenting skills; child physical activity, eating behaviours, and food and beverage choices; family mealtime, media and sleep routines; and parent health behaviours, and associations with food and housing insecurity. A three-class model was chosen based on conceptual interpretation and model fit. Profiles were differentiated by parenting skills, child food choices, child physical activity habits, family mealtime, media, and sleep routines, and parent health behaviours. Food and housing insecurity were associated with class membership while child and caregiver anthropometrics were not. Distinct profiles existed among this low-income, racially/ethnically diverse sample of children with elevated BMI. Such findings emphasize the importance of assessing individual and interpersonal influences and contextual factors on childhood obesity.